Spinal dysraphism in children: An overview and an approach to prevent complications

Sutherland, Ronald S.; Mevorach, Robert A.; Baskin, Laurence S.; Kogan, Barry A.

doi:10.1016/s0090-4295(99)80210-6

Cited by 39 publications

(20 citation statements)

References 63 publications

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“…Although CISC is partly used to protect against renal deterioration, 25 we had expected greater benefit from this method in terms of continence. Perhaps this method is not carried out optimally by many patients, which might be related to possible cognitive impairments.…”

Section: P-valuementioning

confidence: 99%

High prevalence of incontinence among young adults with spina bifida: description, prediction and problem perception

et al. 2005

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Study design: Cross-sectional study. Objectives: To study the prevalence of incontinence, problem perception and determinants of urinary and faecal incontinence in young adults with spina bifida. Setting: Nation-wide study in the Netherlands. Participants: A total of 179 of 350 invited patients participated, including 37 patients with spina bifida occulta and 142 with spina bifida aperta, of whom 119 had hydrocephalus; 41% were male and mean age was 20.4 (range 16-25 years). Methods: Data were collected from interviews, physical examination, neuropsychological tests and medical records. Results: Urinary and faecal incontinence was common in young adults with spina bifida (60.9 and 34.1%, respectively), regardless of the bladder and bowel management they used. The majority of urinary and faecal incontinent patients perceived this as a problem (69.7 and 77.0%, respectively). Spina bifida aperta, hydrocephalus and a level of lesion of L5 or above were associated with patients suffering from urinary and/or faecal incontinence. Predictors of perceiving urinary incontinence as a problem were, in addition to being incontinent, not having hydrocephalus and having a level of lesion of L5 or above. The only predictor of perceiving faecal incontinence as a problem was the frequency of incontinence. Conclusion: A majority of young adults with spina bifida suffer from urinary and faecal incontinence and most of them perceive their incontinence as a problem. Therefore, further efforts are important to improve urinary and faecal continence.

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Section: P-valuementioning

confidence: 99%

High prevalence of incontinence among young adults with spina bifida: description, prediction and problem perception

et al. 2005

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“…4 In addition there may be spinal cord abnormality requiring neurosurgical intervention and, although controversial, spinal cord untethering in those in whom the spinal cord is tethered may prevent further deterioration and improve long term bladder and neurological function. [5][6][7][8] Normal bladder function depends on intact interactions between sacral spinal nerves and the cerebral cortex. 9 Neuropathic bladder dysfunction may result from a variety of spinal cord abnormalities including spinal cord trauma, transverse myelitis, or spinal cord tumour.…”

mentioning

confidence: 99%

“…4 Closed spina bifida results from a failure of closure of the neural tube during the first 28 days of embryogenesis, the defect being covered by skin. This may be associated with a variety of developmental abnormalities of the spinal cord, 5 and indicated clinically by cutaneous abnormalities of the lower back overlying the lumbosacral spine, abnormal lower limb neurology, or orthopaedic abnormalities such as talipes and leg shortening. 8 Other factors associated with spinal cord abnormality include anorectal anomalies, 12 a family history of spina bifida, 5 and a maternal history of pregestational insulin dependent diabetes mellitus.…”

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confidence: 99%

“…This may be associated with a variety of developmental abnormalities of the spinal cord, 5 and indicated clinically by cutaneous abnormalities of the lower back overlying the lumbosacral spine, abnormal lower limb neurology, or orthopaedic abnormalities such as talipes and leg shortening. 8 Other factors associated with spinal cord abnormality include anorectal anomalies, 12 a family history of spina bifida, 5 and a maternal history of pregestational insulin dependent diabetes mellitus. 5 In addition, complex abnormalities of the lumbosacral spine may be detected on plain spinal x rays.…”

mentioning

confidence: 99%

“…8 Other factors associated with spinal cord abnormality include anorectal anomalies, 12 a family history of spina bifida, 5 and a maternal history of pregestational insulin dependent diabetes mellitus. 5 In addition, complex abnormalities of the lumbosacral spine may be detected on plain spinal x rays. However, failure of fusion of the fifth lumbar (L5) and first sacral (S1) vertebral arches alone should be distinguished from closed spina bifida.…”

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confidence: 99%

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Investigation of daytime wetting: when is spinal cord imaging indicated?

Wraige

2002

Archives of Disease in Childhood

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Background: Most children with daytime wetting have detrusor instability. A minority have neuropathic vesicourethral dysfunction. The commonest cause is spina bifida, which may be closed. Clinical features suggestive of closed spina bifida include cutaneous, neuro-orthopaedic or lumbosacral spine x ray abnormalities, impaired bladder sensation, and incomplete bladder emptying. MRI is the ideal method for detecting spinal cord abnormality. It has been suggested that MRI spine is an unnecessary investigation in children with daytime wetting in the absence of cutaneous, neuro-orthopaedic, or lumbosacral spine x ray abnormalities. Aim: To clarify indications for magnetic resonance imaging (MRI) of the spine in children with voiding dysfunction. Methods: Retrospective study of children with voiding dysfunction referred from the Guy's Hospital neurourology clinic for MRI spine between April 1998 and April 2000. Clinical notes and results of investigations, including urodynamic studies and MRI spine were reviewed. Results: There were 48 children (median age 9.1 years). Closed spina bifida was detected in five, of whom four had neuropathic vesicourethral dysfunction confirmed by urodynamic studies. Impaired bladder sensation and incomplete bladder emptying were more frequent in these children than in those with normal MRI spine. One child with spinal cord abnormality had no cutaneous, neuro-orthopaedic, or lumbosacral spine x ray abnormalities. Conclusion: Spinal cord imaging should be considered in children with daytime wetting when this is associated with impaired bladder sensation or poor bladder emptying, even in the absence of neuroorthopaedic, cutaneous, or lumbosacral spine x ray abnormalities.

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Uroneurological assessment of spina bifida cystica and occulta

Sakakibara

Hattori

Uchiyama

et al. 2003

Neurourology and Urodynamics

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Spina bifida cystica and occulta present with a wide spectrum of urodynamic abnormalities including upper and lower motoneuron types of bladder and urethral dysfunction. Careful uroneurological assessment and spinal magnetic resonance imaging are important for diagnosing young adult patients with spina bifida occulta because they may present with urinary symptoms as the sole initial complaint and have no other obvious neurological abnormalities.

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Spinal dysraphism in children: An overview and an approach to prevent complications

Cited by 39 publications

References 63 publications

High prevalence of incontinence among young adults with spina bifida: description, prediction and problem perception

High prevalence of incontinence among young adults with spina bifida: description, prediction and problem perception

Investigation of daytime wetting: when is spinal cord imaging indicated?

Uroneurological assessment of spina bifida cystica and occulta

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